Provider Demographics
NPI:1316367618
Name:KELLEY, WENDY LYNN (DPT)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:LYNN
Last Name:KELLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14532
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-4532
Mailing Address - Country:US
Mailing Address - Phone:330-441-1241
Mailing Address - Fax:
Practice Address - Street 1:30 ROTHROCK LOOP STE B
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1331
Practice Address - Country:US
Practice Address - Phone:330-666-2228
Practice Address - Fax:330-666-2223
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH47642251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1316367618OtherNPI